What happens if you don't match?

[lost premed]

MS3 here, highly interested in EM but concerned about matching with some legitimate reasons. I know what exactly I am lacking in my application (step 1 score) and know what I need to do to maximize my changes from here, but I am trying to prepare for the worst case scenario. What happens to people interested in EM that don't match (assuming they applied to a fair number of programs)? Do they apply again? What do they do with the year off? I'm assuming research wouldn't really boost your application much in terms of EM (also have research under my belt already). Has this happened to anyone? Did you apply again? Did you end up matching into a different specialty? Are there statistics out there on the likelihood of matching as a re-applicant?

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[deleted109597]

1. They scramble (or whatever it's called now. SOAP)
2. Sometimes
3. If they take a year off that's a bad move. Do an internship, not research
4. Many people
5. Yes
6. Ended up EM
7. Yes, but the rate of match is much lower than the graduating resident.

 

[deleted436726]

1. They scramble (or whatever it's called now. SOAP)
2. Sometimes
3. If they take a year off that's a bad move. Do an internship, not research
4. Many people
5. Yes
6. Ended up EM
7. Yes, but the rate of match is much lower than the graduating resident.

With regard to #7, is there any information on the match rate of reapplicants coming from a TY or prelim year?

 

[RainbowOtterz]

What happens to people interested in EM that don't match (assuming they applied to a fair number of programs)? They SOAP more or less. Sometimes that is into a prelim to reapply sometimes it is to match into a categorical spot in another speciality. Some people leave medicine. To leave medicine all together is risky.

Do they apply again? see above.

What do they do with the year off? Prelim year in medicine or surg is the most commonly recommended thing to do in that year. It will make you a stronger reapplicant. That being said in that year you need to try and fix what's wrong with your application and why you didn't match.

I'm assuming research wouldn't really boost your application much in terms of EM (also have research under my belt already). ^correct

Has this happened to anyone? Me

Did you apply again? yes, I did a prelim spot at a competitive surgery program in the NE. I matched at a very good ED program in the SW.

Did you end up matching into a different specialty? No

Are there statistics out there on the likelihood of matching as a re-applicant? there is no data out there. Your chances are very poor to rematch.

 

[gamerEMdoc]

This re-application guide goes over what happens if you don't match and still want to do EM; lots of good info here.

https://www.cordem.org/globalassets/files/committees/student-advising/applying-guide---re-applicant.pdf

 

[gamerEMdoc]

With regard to #7, is there any information on the match rate of reapplicants coming from a TY or prelim year?

there is no data out there. Your chances are very poor to rematch.

As far as I know there isn't data saying how many re-applicants applied last year, but we do know how many spots were filled by re-applicants, at least for MDs. The data is off somewhat though because of the way the NRMP counts re-applicants (see below).

In 2019:

# of spots in EM: 2488
# filled by MD seniors: 1617
# filled by DOs: 648
# filled by US-IMGs: 112
# filled by foreign IMGs: 27
# filled by US MD previous graduates: 54
# filled in the scramble: 30

So the data would suggest that only 54 of 2488 spots were filled by re-applicants, but that's lower than the actual number. The exact number isn't known, because of the way NRMP categorizes applicants. The only "re-applicants" that get their own data are US MDs who previously graduated (ie candidates who are no longer in med school when they apply). So DO's and IMGs that are re-applying are counted in their respective groups, not the re-applicant group. So that makes the number of re-applicants that match lower, since there are definitely DO re-applicants that match.

So who knows. The odds are lower, obviously. The number that try to reapply is likely low to begin with, since most people that scramble I'd imagine just decide to finish out whatever residency they scrambled into.

 

[CajunMedic]

If you haven't already, you can also play with the numbers on the interactive charting outcomes data that NRMP put out this year and see where you may fall.
Interactive Charting Outcomes in the Match - The Match, National Resident Matching Program

I'm a DO, and my initial match was one of the last ones of the 2 match system.

1. I unsuccessfully tried to scramble in the DO match and withdrew from the MD match. I chose to take an osteopathic TRI that was connected to an EM program. One of my classmates did the same thing. Several of my friends that didn't match EM this year successfully SOAPed into spots. I also looked into programs that were accredited after the match, Interviewed at one. That's an option as well.

2. Several of us applied again. All of us from my TRI (now TY) that were interested in EM all matched. 4 of the 5 stayed there, I chose to rank someone else #1 and matched at that program. My classmate was a TRI at a different institution matched at their program as well

3. As posted above. don't take the year off. Do a TY, or prelim year, preferably one at an institution that has an EM program. The face time helps, plus you may be able to get updated SLOE's

4. Research doesn't really help. Killer SLOE's and Crushing Step 2 would be better

5. Happened to me, I refused to give up on my dream of EM. I matched at my #1 EM program

6. No good data out there as far as reapplicants go, other than the link I posted above


In an interesting twist, I matched at my #1, which promptly closed 45 days after I started. Transferred to the program I had tried to scramble to when I didn't match the first time.

 

[TheSingularity]

The good thing about not matching is that you don't have to do EM.

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[deuist]

Lots of good info on this board. I won't echo what everyone else has said except to say that you should realize that not matching is not the end of the world. You might find something during internship that you enjoy and decide to switch specialties. I've known people who switched into anesthesiology, radiology, surgery, etc. Since they had completed a PGY-1 in surgery, they were able to go directly into PGY-2.

Research is not particularly sought after by EM programs. If you decide to pursue another competitive specialty such as derm, then research might be useful. Even then, the people I've known who switched to derm still did a PGY-1 first.

 

[TheSingularity]

There are plenty of highly academic programs that would value legitimate research. I graduated from one.

Lots of good info on this board. I won't echo what everyone else has said except to say that you should realize that not matching is not the end of the world. You might find something during internship that you enjoy and decide to switch specialties. I've known people who switched into anesthesiology, radiology, surgery, etc. Since they had completed a PGY-1 in surgery, they were able to go directly into PGY-2.

Research is not particularly sought after by EM programs. If you decide to pursue another competitive specialty such as derm, then research might be useful. Even then, the people I've known who switched to derm still did a PGY-1 first.

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[deuist]

There are plenty of highly academic programs that would value legitimate research. I graduated from one.

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Your program preferred a research year to an internship for non-matched applicants?

 

[ShockIndex]

Your program preferred a research year to an internship for non-matched applicants?

I’ve seen people not match due to ****ty Board scores, red flag comments in SLOEs, and awkward personality traits coming across on interviews. However, I’m not aware of anyone who failed match in EM due to a lack of research. So, that begs the question - is the year spent doing research really going to address the deficiencies in the application? Better yet, most people will struggle to do legit research in one year unless they have a project in med school already on the burner.

 

[gamerEMdoc]

Correct. And while there are highly academic programs that value research, these same places are probably not the most likely to take someone who failed to match the previous cycle. In terms of getting the most bang for your buck, doing a TY, especially at a place with an EM program, is far more valuable than doing a year of research.

 

[Mat the coolcat]

I'm also someone who didn't match (got sandbagged by a SLOE from a douchebag institution), and I know a LOT of people who have done TRI's/surgical prelimb years that were successful the second time around.

If it's board score you're worried about, don't fret yet. I'm a DO, but I know a couple of my MD colleagues who scored VERY poorly on their step 1 and 2 (like 200-210) and matched at fantastic programs and had to turn down interviews because of their good SLOE's. Also know DO's that have done well with the match with good SLOE's, but it is admittedly a little harder, and you'll have to pick your away rotations very carefully. Bang out the step 2 and you'll be good, and don't fail the CE exam.

God forbid you don't match, getting a TRI or surgical prelimb year at a place with an EM program is key. That way you can get a new SLOE, and it will likely be better too, because they'll get to see you work as a resident, and not just a student who can only sew lacs and alert the physician on lab results...

 

[lost premed]

So much good information on here. Thank you everyone, I found all of this very insightful and I'm sure it will help many others that are in a similar shoe.

 

[bravotwozero]

like McNinja and others, I also failed to match on my first go, and did a couples match. Crappy SLOR sunk my app. Re-applied and matched successfuly, albeit with less interviews. The advantage I had going for me was I matched into an internship at a hospital that had an in house EM program, where I was able to rotate and get a good SLOR.

 

[general987]

I had a low step 1 score and an average step 2 score and managed to match first time round. The key I think was showing improvement on step 2 and having average to good SLOEs. I have had classmates with worse quantitative scores than me get into fantastic programs because their SLOEs were off the charts. I think if you can't mitigate the scores, maximizing the SLOEs will have the best yield for you. Hindsight, I should have done one of my SLOEs at an institution I knew closer to home instead of one 8 states away because it ended up being an average letter. I think I would have performed better at the more familiar institution. Just my 2 cents. Most of my friends who didn't match (this is observational) was due to a subpar or bad SLOE. I had a friend who was in the mid 240s step 1 and good Step 2 score who didn't match because one of 2 of his SLOE (the other was good) was terrible. He is now in EM second time round.

You got this. Stay focused on the goal, study EM hard, and impress away rotations with your commitment to EM, work ethic, and acquired knowledge in EM and I guarantee you will match.

 

[miacomet]

You pick another specialty that might not be oversubscribed and might actually have a future?